AHA says 'bar too high' for Stage 2

WASHINGTON – With the May 7 closing of the comment period on the proposed rule for meaningful use Stage 2, stakeholders weighed in. Many wrote the rules were asking too much.

“Taken as a whole, the proposed requirements for meeting Stage 2 raise the bar too high and are not feasible for the majority of hospitals to achieve,” American Hospital Association Executive Vice President Rick Pollack wrote in the AHA comment letter,

According to Pollack, the vast majority of hospitals – more than 80 percent – have not yet met Stage 1, due to both the high bar set and market factors, such as accelerating costs and limited vendor capacity.
The AHA targeted the patient portal section of the proposed rule that calls for providing patients with discharge information electronically within 36 hours.

The AHA argues that the objective is counter to HIPAA privacy and security rules and recommends the objective be removed for two reasons: “(1) CMS does not have regulatory authority over patients’ access to their health records; and (2) the objective is not feasible as specified.”

Critics say the argument is spurious – simply a way to delay patient engagement.

“We felt the approach taken in Stage 1 gave providers much-needed time to make sure the correct fields were populating and accurate meaningful use reports were being produced," said Pam McNutt, senior vice president and CIO at Dallas-based Methodist Health System. “We think a similar approach is needed for Stage 2 and beyond.”

The HIMSS Electronic Health Records Association praised the decision to delay Stage 2 by a year, allowing more time for development and testing. It, too, recommended using a shorter reporting period than the 12 months specified in the proposed rule. Three months, or six months would be better, the association wrote.

The American Medical Association said changes "are necessary to ensure that the meaningful use program lives up to its intended purpose." The AMA also sought more flexibility.

“The AMA is supportive of widespread adoption and meaningful use of EHRs by physicians, but the cumbersome proposed criteria will make successful physician participation extremely difficult,” said AMA Board Chair-elect Steven J. Stack, MD.

The Premier healthcare alliance urged the government to publish a final rule no later than August 2012 – or to extend Stage 1 for one more year.